Healthcare Provider Details

I. General information

NPI: 1568371144
Provider Name (Legal Business Name): JESSICA KNOELL PLMHP #15104
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13121 COUNTY ROAD 16
BLAIR NE
68008-5674
US

IV. Provider business mailing address

4151 W COUNTY RD S
FREMONT NE
68025-9068
US

V. Phone/Fax

Practice location:
  • Phone: 402-426-9020
  • Fax:
Mailing address:
  • Phone: 402-720-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: